使用病例控制设计在重症监护室创建侵入性角膜炎的预测模型:一种欧洲多中心方法
P M B Benders1, J Schouten2, A Vena3
1Department of Anesthesiology, Radboudumc, Nijmegen, The Netherlands.
BMC infectious diseases
|May 4, 2025
概括
在重症监护室 (ICU) 患者中预测侵袭性候群病 (IC) 很困难. 使用国际数据的新模型显示,临床使用的预测性能有限.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 医疗信息学 医疗信息学
背景情况:
- 侵入性候群病 (IC) 在重症监护室 (ICU) 患者的发病率和死亡率显著增加.
- 目前用于IC的诊断方法缺乏灵敏度,延迟或未经验证用于常规使用.
- 早期治疗对于改善IC患者的生存率至关重要.
研究的目的:
- 为了确定使ICU患者易患侵袭性候群病的因素.
- 使用大型国际数据集开发和验证IC的替代预测模型.
主要方法:
- 从EUCANDICU数据库中对285个病例和285个匹配的对照进行了追溯分析.
- 通过单变量分析确定了31个独立的风险因素.
- 在80%的数据上使用LASSO回归的预测模型的开发,在剩余20%的数据上进行验证.
主要成果:
- SAPS II评分,SOFA评分,先前感染,功能障碍和多个Candida定居点独立地与IC风险增加有关.
- 一个包含22个变量的Lasso回归模型实现了0.7433.3的AUROC.
- 该模型的预测性能不足以用于临床应用.
结论:
- 开发一种可靠的预测模型,用于ICU患者的侵入性角膜炎仍然是一个重大挑战.
- 尽管使用了大型跨国数据库和先进的方法,但当前模型的性能对于临床实践是不够的.
- 需要进一步的研究,以改善在重症患者中IC的预测.
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